Filippo Marchi, Andrea Iandelli, Gian Marco Pace, Elisa Bellini, Alessandro Tirrito, Andrea Costantino, Luca Cerri, Antonio Greco, Antonella Polimeni, Giampiero Parrinello, Giorgio Peretti, Armando De Virgilio
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A total of 305 patients (males: 80.8%, n = 232/281), with a median age of 56.1 years (n = 305/305; 95% CI 53.9-63), who underwent a total of 307 PAP flap reconstructions for head and neck defects were included. Flap survival rate was 100% (n = 306/307; 95% CI 99.6%-100%), with a reoperation rate for major complications of 3.7% (n = 15/307; 95% CI 1.85%-6.1%) and an overall complication rate of 26.5% (n = 92/307; 95% CI 15.7%-38.9%). Notable postoperative complications included wound dehiscence (n = 15/307, 4.9%), delayed healing (n = 14/307, 4.6%), and wound infection (n = 12/307, 3.9%). 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PAP flap might be considered as a compelling alternative to the traditionally employed soft tissue free flaps in head and neck reconstruction.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Surgical outcomes of profunda artery perforator flap in head and neck reconstruction: A systematic review and meta-analysis.\",\"authors\":\"Filippo Marchi, Andrea Iandelli, Gian Marco Pace, Elisa Bellini, Alessandro Tirrito, Andrea Costantino, Luca Cerri, Antonio Greco, Antonella Polimeni, Giampiero Parrinello, Giorgio Peretti, Armando De Virgilio\",\"doi\":\"10.1002/hed.27891\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aims to evaluate the efficacy of the profunda artery perforator (PAP) flap in head and neck reconstruction.</p><p><strong>Methods: </strong>A single arm meta-analysis was performed for flap survival rate (primary outcome), reoperation for major complication, and overall complication rates (secondary outcomes).</p><p><strong>Results: </strong>The search strategy yielded a total of 295 potentially relevant publications, of which 13 were included. 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引用次数: 0
摘要
研究目的本研究旨在评估深动脉穿孔器(PAP)皮瓣在头颈部重建中的疗效:方法:对皮瓣存活率(主要结果)、主要并发症再手术率和总体并发症发生率(次要结果)进行单臂荟萃分析:搜索策略共搜索到 295 篇潜在相关文献,其中 13 篇被纳入。共纳入 305 名患者(男性:80.8%,n = 232/281),中位年龄为 56.1 岁(n = 305/305;95% CI 53.9-63),他们因头颈部缺损接受了 307 例 PAP 皮瓣重建术。皮瓣存活率为 100%(n = 306/307;95% CI 99.6%-100%),主要并发症的再手术率为 3.7%(n = 15/307;95% CI 1.85%-6.1%),总并发症率为 26.5%(n = 92/307;95% CI 15.7%-38.9%)。显著的术后并发症包括伤口开裂(n = 15/307,4.9%)、延迟愈合(n = 14/307,4.6%)和伤口感染(n = 12/307,3.9%)。部分皮瓣坏死和血肿发生率为 2.6%(8/307),动脉和静脉血栓形成率分别为 0.7%(2/307)和 1.3%(4/307):结论:PAP皮瓣在头颈部重建中的应用显示出多个有利方面,如皮瓣失败率极低、可实现不同尺寸的多功能性以及并发症发生率相对较低。在头颈部重建中,PAP皮瓣可被视为传统软组织游离皮瓣的替代品。
Surgical outcomes of profunda artery perforator flap in head and neck reconstruction: A systematic review and meta-analysis.
Objective: This study aims to evaluate the efficacy of the profunda artery perforator (PAP) flap in head and neck reconstruction.
Methods: A single arm meta-analysis was performed for flap survival rate (primary outcome), reoperation for major complication, and overall complication rates (secondary outcomes).
Results: The search strategy yielded a total of 295 potentially relevant publications, of which 13 were included. A total of 305 patients (males: 80.8%, n = 232/281), with a median age of 56.1 years (n = 305/305; 95% CI 53.9-63), who underwent a total of 307 PAP flap reconstructions for head and neck defects were included. Flap survival rate was 100% (n = 306/307; 95% CI 99.6%-100%), with a reoperation rate for major complications of 3.7% (n = 15/307; 95% CI 1.85%-6.1%) and an overall complication rate of 26.5% (n = 92/307; 95% CI 15.7%-38.9%). Notable postoperative complications included wound dehiscence (n = 15/307, 4.9%), delayed healing (n = 14/307, 4.6%), and wound infection (n = 12/307, 3.9%). Partial flap necrosis and hematoma occurred in 2.6% of cases (n = 8/307), while arterial and venous thrombosis were documented in 0.7% (n = 2/307) and 1.3%, respectively (n = 4/307).
Conclusion: The application of the PAP flap in head and neck reconstructions showed several favorable aspects, such as an exceptionally low flap failure rate, versatility in achieving variable dimensions, and a relatively low incidence of complications. PAP flap might be considered as a compelling alternative to the traditionally employed soft tissue free flaps in head and neck reconstruction.
期刊介绍:
Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.